Individual
JUAN DEZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7910 FROST STREET, SUITE 245, SAN DIEGO, CA 92123
(858) 650-5037
(858) 650-5039
Mailing address
7910 FROST STREET, SUITE 245, SAN DIEGO, CA 92123
(858) 650-5037
(858) 650-5039
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
A45058
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A450580
—
CA
Enumeration date
10/25/2005
Last updated
07/08/2016
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